The Group of 20 announced the winners of the G20 Challenge on Inclusive Business Innovation, a global competition managed by IFC, a member of the World Bank Group at the G20 Summit in Los Cabos, Mexico, on June 18, 2012. Apollo Hospitals was declared a winner (the only healthcare organization in the World) for it’s Reach Hospitals initiative. Apollo Reach Hospitals is an initiative of the Apollo Hospitals Group to take quality tertiary healthcare to semi-urban and rural areas in the country. Apollo Hospitals Group provides specialized medical services in India’s underserved rural areas and smaller towns. Apollo Reach Hospitals were created to bridge the healthcare access gap by making specialized healthcare available to the poorest people. The Apollo Reach Hospital in Karimnagar, Andhra Pradesh was chosen by Apollo Hospitals Group to represent its model in the G20 Challenge. Dr. Manmohan Singh, Hon’ble Prime Minister of India inaugurated this facility in 2008. This pioneering initiative of the Apollo Hospitals Group aims to reach world-class healthcare to semi urban and rural India. Apollo Reach has a wide array of offerings apart from regular medical facilities, including pharmacies to insurance services. Ms Preetha Reddy, Managing Director, Apollo Hospitals Group said, “We are extremely proud to be recognized by the G20 for our efforts in bringing about a visible change in the lives of people at the bottom of the pyramid (BOP). More than 25 percent of families in India live on the margins, spending less than US$70 a month on goods and services. Many of their basic needs go unmet, and they have little access to clean water, financial services, and education. More than 85 percent of these families live outside major cities. Unfortunately, most tertiary healthcare facilities in India are located in major metropolitan areas – meaning that most Indians have little or no access to specialized healthcare services. We consider it our responsibility to extend the same kind of healthcare services and facilities to smaller towns. This is our way of reinvesting in the ecosystem and contributing to the Indian society at large.” Apollo Reach Hospitals operate in less-developed population centres – termed Tier II cities – and offer medical care at rates up to 30 percent lower than other major hospitals. Within Reach Hospitals, low-income care is subsidized by services sold to high-income patients from the same area. The world’s leading economies launched the G20 Challenge to rapidly expand commercially viable businesses that serve the large numbers of low-income people that constitute the base of the global economic pyramid. Its goal is to identify, showcase, and support innovative business models that can be replicated across developing countries. The online competition was launched to find the best examples worldwide of businesses in developing countries that provide critical goods, services, and livelihood opportunities in financially, environmentally, and socially sustainable ways to those living at the bottom of the pyramid, called ‘inclusive businesses’. The G20 Challenge on Inclusive Business Innovation recognized businesses with innovative, scalable, and commercially viable ways of working with low-income people in developing countries. An independent judging panel – including representatives from the G20, the private sector, academia, foundations, and International Finance Institutions – selected 15 Challenge winners based on the following criteria: Innovation Development results Potential for growth, including replication of the business model in other markets Financial sustainability Environmental and social sustainability “The winners demonstrate that commercially viable companies can also provide economic opportunities for poor people-along with better access to clean water, electricity, health care, education, housing, phone services, and financial services.” said Lars Thunell, IFC Executive Vice President and CEO. “They provide impressive models for others to follow.” The awards were presented by Ambassador Rogelio Granguillhome, Chair of the G20 Development Working Group, Dr. Edmund Duckwitz, Ambassador of Germany to Mexico and Mr.Lars Thunell, Executive Vice President of IFC at a grand award ceremony on June 18, 2012.  

Apollo Hospitals has formed a subsidiary to impart healthcare-related training to 392,000 people in 10 years. NSDC has agreed to buy a stake in Apollo Med Skills Ltd., a Unit of the Apollo Hospitals Group. The investment on the project will be around Rs. 39 crore, of which NSDC will loan Rs. 25.13 crore to Apollo Med Skills. Apollo will contribute Rs. 9.88 crore. NSDC will also buy a 27% stake in Apollo Med Skills for Rs. 3.65 crore. Dr.K. Prabhakar, Chief Executive Officer of Apollo Med Skills, said the company is entering the sector because it realises the requirement for trained manpower. Dr.Prabhakar said the group formed the unit towards the end of 2011 and was engaged with NSDC for the partnership. “”We have now got their board approval,”” he said. The company will train people in subjects such as medical lab technology, dialysis and non-invasive cardiac courses, radiology and imaging, and operation theatre technology. It will also train doctors and nurses to update their skills. Ms.Sangita Reddy, executive director of operations at Apollo Hospitals, will oversee the work of the training subsidiary as a director. NSDC representative said. “”Since they are an established player, we can expect complete commitment from them.”” The company plans to set up about 47 centres in Andhra Pradesh, Tamil Nadu, Bihar, Orissa, Jharkhand, Karnataka and West Bengal. “”Since, we have partnered with NSDC, we can use some government school buildings for running classes, especially in the evenings,”” Dr.Prabhakar said. Apollo will also find jobs for the trained people in its hospitals and other healthcare centres.  

Apollo Cancer Institute, Chennai urges people to kick tobacco chewing and smoking habits and organizes activities in collaboration with Madras Road Transport Corporation to create awareness on Oral & Lung cancer on the occasion of “”World No Tobacco”” day on May 31st. “”World No Tobacco”” Day (WNTD) is observed around the world every year on May 31. It is meant to encourage a 24-hour period of abstinence from all forms of tobacco consumption across the globe. The day is further intended to draw global attention to the widespread prevalence of tobacco use and to negative health effects, which currently lead to 5.4 million deaths worldwide annually. According to WHO tobacco is the second major cause of death worldwide. For creating the awareness for oral and lung cancer and also the harmful effects of tobacco usage, Apollo Speciality Cancer Hospital arranged a series of activities, throughout the no tobacco campaign week. With the mission of making Chennai a healthy city, Apollo Cancer Institute, Chennai have collaborated with Madras Road Transport Corporation (MTC) & organized series of activities on this occasion. An awareness talk and Pulmonary function tests were organized for the staff of Madras Transport Corporation. Usually the drivers from MTC are more prone to hazards of pollution & they are also in the forefront of active as well as passive smoking and chewing tobacco, in order to reduce the stress that they come across in their day today work. Keeping this in mind, Apollo Cancer Institute has taken the initiative to educate the staff of MTC against the harmful effects of tobacco & smoking. More than 500 employees from Madras Transport Corporation are expected to benefit from this test conducted. Apart from this major campaign Apollo has also initiated various activities, focused on PSUs, Corporates to create awareness on the harmful effects of smoking & tobacco. Again, PFT test is being conducted and awareness talks are organised at these Corporates to highlight on the need for a Healthy Life style & importance of regular cancer screening. Around 10 Corporates have been screened throughout the week, which includes screening of more than 1000 people. The workforce which includes more than 5000 people, have been given awareness on the hazards of smoking and chewing tobacco through awareness talks by Cancer Specialists from Apollo Speciality Cancer Hospital. The Corporates have also joined wholeheartedly in this noble initiative from Apollo Hospitals.  

S.N. Bhatt (now 94 years) and Vijay Laxmi Bhatt (now 87) who underwent Total Knee Replacement at Apollo Hospitals Delhi have become the oldest couple in the country to undergo bilateral total knee replacement (TKR) in a single sitting. While Mr. Bhatt underwent TKR of both knees (bilateral) in a single operation (under same anaesthesia) in April last year at Indraprastha Apollo Hospital here, his wife was successfully operated upon six months later. Indraprastha Apollo Hospital senior consultant orthopaedics and joint replacement surgeon Dr. Raju Vaishya who operated on the duo has now filed for a new record with the Limca Book. Mr. Bhatt, who retired as Principal of a degree college, played hockey along with the late legendary Dhyanchand when he was young and an avid horse rider as well. “”With this surgery it’s like a new lease of life for me and I feel like playing hockey again!”” he said at a Press conference. He said that before the surgery he was forced to use a wheelchair because of acute arthritis. His son who is an anaesthetist encouraged him to go in for TKR. “”An active schedule in his prime years enabled Mr. Bhatt to keep lifestyle diseases at bay and besides arthritis and mild hypertension he had no other ailment before the surgery. However, he had huge defects in the tibia (shin bone) which required bone grafting and therefore his surgery lasted about three hours. Mr. Bhatt started walking in four days post surgery and was discharged from the hospital after six days. And with this, he also entered the Limca Book of Records as the world’s oldest man to have undergone bilateral TKR in a single sitting,”” said Dr. Raju Vaishya. Delighted at being able to perform activities of daily living with complete ease, he convinced his wife, Vijay Laxmi, to undergo bilateral TKR in a single sitting as well. Vijay Laxmi was operated in November last year — six months after her husband’s surgery — despite ischemic heart disease. “”This makes them the oldest living couple in the country to undergo bilateral TKR in a single sitting,”” said Dr. Vaishya. The physician noted that TKR is one of the most successful orthopaedic surgeries that have even surpassed the outstanding long-term results of total hip replacement.  

Dr Ananthakrishnan Sivaraman, Consultant Urologist has been conferred a Special Achievement Award in Robotic Surgery by the Bengal Urological Society at Bengal Urology Society Conference( BUSCON) as part of their 50th Anniversary celebrations held in Kolkata. The award was given by Ms Chandrima Bhattacharya, Health Minister of Bengal on November 24th 2013. The award has been given as recognition to his efforts in initiating, facilitating and mentoring robotic surgeons in Kolkata over the past one year. A live work shop on robotic urological procedures was conducted where Dr Ananthakrishnan was the Faculty. Four robotic surgeries were performed as part of the work shop.                       

To mark the International Nurses Day on 12 May 2012, Apollo Group of Hospitals organized the 3rd National Nursing Conclave 2012 at Apollo Hospitals Bangalore, in association with innovative products maker and research and development leader 3M, to help nurses, their leaders and educators build confidence in the complex medical environment and meet patient expectations in a holistic manner. This will be followed by two days of leadership summit. Dr E. V. Ramana Reddy, Secretary – Health and Family Welfare, Government of Karnataka was the chief guest for the conclave. The keynote address was delivered by Dr (Ms) Preetha Reddy, Managing Director, Apollo Hospitals Group. Dr E. V. Ramana Reddy said: “”This is a novel idea to recognize the key role played by nurses in providing healthcare to the people. There has to be a commitment towards achieving good health for all, which must be a country-wide goal. Quality healthcare provisions and their easy accessibility are paramount in a country like India with a population of over a billion. Care is most needed for patients with progressive and life-threatening diseases such as cancer. Nurses must understand their crucial role in bringing health to the ill.”” In her keynote address, Dr (Ms) Preetha Reddy said: “”Care-giving standards and procedures need to be improved across the country. Today’s healthcare settings are quite complex compared to earlier times. In such a scenario, it becomes imperative for nurses to understand the care environment and its requirements so that they can work and serve with confidence despite numerous expectations. Apollo has always tried to develop leadership expertise in nurses besides the necessary care-giving skills. By giving confidence, strength and varied opportunities to the nursing staff, we appreciate their efforts in serving the patients.”” Roadblocks in quality healthcare, medical errors, nursing education, need for nurses to take care of themselves and importance of communication to provide care to others were mooted by way of debates, panel discussions and paper presentations. Capt. Usha Banerjee, Group Director – Nursing, Apollo Hospitals Group, Ms Mary Jose, Director – Nursing, Apollo Hospitals Bangalore and Mr Gautam Khanna, Executive Director, Healthcare Business, 3M India were also present. Capt. Usha Banerjee said: “”With the theme – ‘Caring with Confidence – Building People — this conclave provides a platform for exchange of views among nursing professionals to overcome various challenges they face while taking care of patients. Sharing research outputs and sustainable solutions is important for improving healthcare in the long run. Upcoming nurses must enter their profession with a clear understanding and know-how of its demands. Quality nursing education with emphasis on developing the required skill set will go a long way in the much-needed advancement of nursing standards in the country.”” Mr Gautam Khanna said: “”Superior standards of healthcare practices can only be ensured through adequate training of healthcare providers like the nursing community. 3M’s collaborations with associations like Infusion Nurses Society, Critical Care and Operating Room Nursing Clubs bears testimony to our support for the nursing fraternity. Forums such as these are an excellent platform to engage care-givers and share best practices in healthcare delivery.”” International Nurses Day is celebrated on 12 May every year, which is the birth anniversary of legendary nurse Florence Nightingale – the founder of modern nursing.  

Advancement in technology plays an important role in the healthcare system, and it offers new and better ways to solve the key health problems of the new century. The latest is the Robotic surgery which has gained rapid acceptance over the past four years as the preferred mode of surgery by doctors and the patients. The Apollo Institute of Robotic Surgery, Chennai launched in November 2011, offers world class treatment extensively in Gynaecology, Urology, Oncology, General and Bariatric Surgery. With the use of the state of the art “”da Vinci Robotic System””, Apollo Hospitals has successfully completed 56 complicated surgeries. With more number of patients opting for the robotically assisted surgery, the institute is planning to expand its reach in Cardiac, Head and Neck Surgeries. This minimally invasive field of surgery has integrated advanced technology with computer enhanced platforms and surgical skills to improve efficiency, precision and safety. Less blood loss, faster recovery with invariably less pain and scar, lesser tissue trauma are some of the aspects that make Robotic surgery preferable to the conventional surgical procedure. Highly complicated surgical tasks beyond the limitations of human hand are successfully treated using EndoWrist instruments attached to robotic arms that are controlled by a Robotic surgeon. Though the robot has no intelligence to conduct any single movement on its own, it is primed to carry out several safety checks per second. Robotic Surgery is the best treatment for patients with obesity and diabetes in addition to those who require complex surgical procedures and for patients who have undergone multiple surgeries. Dr Prathap C. Reddy, Chairman, Apollo Hospitals appreciated the overwhelming response to Robotic Surgery. He said, “”Robotic surgery is developing at a fast pace in India. With the inception of the Robotic era, there is a need to spread awareness on this modality of surgery and its technological benefits. Adopting Robotic Surgeries in various specialties will help patients across all regions to access the benefits of minimal invasive surgery.””  

Aneurysms of thoracic aorta and abdominal aorta are rare and their treatment traditionally involved complex surgical repair with attendant morbidity and mortality. Nowadays, interventional non-surgical management with Endovascular grafting using covered stent grafts (EVAR : Endovascular Aneurysm Repair) has become the treatment of choice in the majority of cases. This is the tale of a 67 year old hypertensive gentleman with Coronary artery Disease presenting with very large saccular Aneurysm in the Descending thoracic Aorta with another large saccular aneurysm in infra-renal abdominal aorta, again with impending rupture and layered clot in the aneurysm sac. He was refused treatment citing high risk as the reason in several placed and came to us as a last resort. A double TEVAR and EVAR procedure was performed by Dr Y Vijayachandra Reddy, Consultant Cardiologist, Apollo Hospitals Chennai. The final result was excellent with no complications and no endo-leaks. Patient withstood the procedure well and was shifted to ICU. He has been extubated and doing well now. The points of interest in this case are 1. Rarity of the procedure – stenting of both thoracic and abdominal aortic aneurysms in the same sitting 2. Aneurysm starting just after the left subclavian artery was considered inoperable because of high surgical risk involved and non interventionable due to lack of good landing zone for stenting. A carotid subclavian bypass was done enabling the case to be made suitable for TEVAR : the perfect example of a hybrid procedure. 3. The anatomy of abdominal aorta Aneurysm was interesting with gross disparity in size and tapering distal end precluding the use of the usual aneurysm stents . A balloon expanding Covered stent was deployed across the abdominal aorta aneurysm with post-dilation to mould the stent to the tapered aorta  

The first ABO-incompatible kidney transplant at the Apollo hospitals Chennai was done by using the Immune adsorption columns to reduce the specific blood group antibody titer before the ABO-incompatible transplant. This is the first case in the country using column adsorption of blood group antibodies . What is Column Adsorption Technology? Traditionally ABO compatible donor organs are essential to achieve a successful organ transplant. Transplantation of solid organs like kidney between donors and recipients of incompatible blood group is usually contraindicated because of the risk of “”hyper acute”” rejection. This rejection occurs due to the presence of pre existing Anti-A or Anti B antibodies in the recipient that can destroy the incompatible donor organ. Limitations in donor availability for organ transplantation makes “”living donor”” solid organ transplantation across the blood group barrier to become an alternative to ABO compatible transplantation for those with end stage renal disease facing long waiting times. This problem has been overcome by using a highly selective procedure to remove the potentially damaging blood group antibodies and slow their production during the critical post operative period. This is achieved by removing the anti-A or Anti B from the recipient using antigen-specific immune adsorption by performing several sessions of plasmapheresis. No other beneficial substances present in the plasma are removed and no plasma substitution is made either. This procedure is supported by a protocol of pharmacological drug based immune suppression and the ABO incompatible kidney transplant is performed. The Glycosorb ABO immunoadsorption column contains ABO blood group antigens covalently bound to sepharose particles. The column is used to deplete anti-A or Anti-B from plasma. Plasma is separated from whole blood in the Apheresis system, processed through the column before it is reinfused. The reinfused plasma is depleted only of the anti-A/B but not the other proteins like the coagulation factors or other antibodies in blood. More than 2000 ABO incompatible kidney transplants have been performed worldwide without any serious side effects using the Column Adsorption technology. Our first case A 52-year old male, a case of Diabetic Nephropathy and advanced chronic Kidney Disease was on regular dialysis. Live related renal transplant was performed but had graft loss due to Renal Artery thrombosis and underwent graft nephrectomy. ABO-incompatible re-transplant (donor-Brother) was planned due to non availability of ABO compatible kidney. Recipient was O Positive and donor A Positive. Patient underwent column adsorption plasmapheresis pre-operatively to reduce the Anti-A titer from 1:256 to 1:4 .This is the first time immunoadsorption therapy was instituted in our country using plasmapheresis. He received the kidney from his brother and had a fairly smooth post operative period in the hospital and was discharged on the 11th post operative day. He had normal kidney function and good urine output. One month after the surgery his kidney functions normally and urine output is good. Patient is back at work 3 months after his surgery.  

The Apollo Foot Care [Electronic Baropaedometer & Insole Maker] Service launched at Apollo Hospitals Chennai has been commenced to help in diagnosis of foot and ankle pains & production of thermoformed plantar insoles to treat them by introducing biomechanical corrections. It would deal with patients not only with foot problems [that may include lower kinetic chain problem, neuropathy, orthopaedic problems] but also fitness, sports, athletes and everyday walker. In short it would cater to both the ends of clientele illness as well as wellness. The service would assess, treat, prescribe, and prepare customized insoles for every patient coming to foot care based on the individual profile and need. Everyone is unique! The focus of the rehabilitation process would be very individual, and is dependent on the nature of the problem. Services Apollo Foot Care would offer services that range from the proactive to the reactive. Offered services include: Foot Assessment Foot Scan – Posturographic Analysis (Static & Dynamic ) & 3D imaging, Foot Pressure Analysis Observational gait Analysis Printed & Descriptive reports Comprehensive Physiotherapy Assessment (as appropriate) Mould Design Insole Design Customised Insole Preparation Foot Care education/advices Foot Wear Advices Rehabilitation/Exercises (as appropriate)   Who we can help? Anyone with Foot, Low back and Lower Kinetic Chain issues Diabetes [Diabetic Foot with certain limitations] Orthopaedic/Musculoskeletal [Plantar Fasciitis, Morton’s Neuroma, Achilles Tendonitis, Heel Spur, etc] Neurological {Tropical Neuropathy] Sports – any sport, athletes especially runners Every day Walker Fitness/Wellness   For further details, contact : Dr. Akilesh Anand Prakash, Consultant – Sports Medicine / Mr. Raj Prasanna, Cheif – Physiotherapy & Rehab The Physiotherapy Department Apollo Main Hospital No.21, Greams Lane, Off Greams Road Chennai – 600 006. Tel. : Board : +91-44-2829 3333 / 2829 0200 Direct : +91-44-2829 6572  

Baby Samreen Fatima, suffering from an inherited condition – progressive familial intrahepatic cholestasis (PFIC) underwent a Liver Transplant at Apollo Hospitals, Delhi. Samreen’s father Malik Sarsa Khan, a Pakistani driver, donated 20% of his liver to his daughter. Malik Khan had lost five children before. So when his daughter (3), who was born seven years after the death of his last child, was diagnosed with liver cancer, he decided to “”beg, borrow or steal”” to fund her liver transplant surgery in India. Though the government of Punjab in Pakistan stepped in to help him financially, he was robbed off at gunpoint in Lahore while on his way to India. A determined Khan, somehow, managed to reach Apollo Hospital in Delhi. When finding a liver donor became difficult, he decided to donate 20% of his organ to his daughter. A 10-hour surgery has cured Samreen. “”Liver transplant surgery for children is not conducted in Pakistan. I was told to go to either China or India. I had more faith in Indian doctors and decided to do whatever it takes to get my daughter under their care. I cannot believe that my daughter, who barely spoke a word, used to be down with high fever almost every alternate day and could not stop itching her body and vomited blood, is talking non-stop these days. She is behaving like any other normal child,”” a beaming Khan said. He added “”I had lost my last child also to liver disease. However, this time I was not going to give up. Doctors said Samreen was suffering from an inherited disease and it could be because I am married to my cousin sister – a practice being followed in my family for over three generations.”” Samreen’s case transcended “”against all odds””, said Dr Anupam Sibal, Group Medical Director, Apollo Hospitals & Pediatric Liver Consultant. “”It was heart-warming to see the commitment of the father to save her daughter. Samreen was very ill when she came to our hospital and we were worried whether she would be fit to withstand the liver transplant. Now, she is cured, and back home,”” said Dr.Sibal. Transplant surgeon Dr Subhash Gupta said Samreen was suffering from an inherited condition – progressive familial intrahepatic cholestasis (PFIC). The liver, one of the largest organs in the body, cleans the blood and helps fight infections. It also stores vitamins, sugars, fats and nutrients that travel to the rest of the body. It also removes billirubin whose presence causes jaundice. The liver is responsible for making bile. The build-up of bile in PFIC causes the liver to be damaged. “”This eventually leads to scarring in the liver that leads to cirrhosis or cancer. If Samreen hadn’t undergone the transplant, she would have died soon,”” Dr Gupta said. He added, “”She was malnourished, unable to walk, eat and be mentally alert. The surgery took about 10 hours. In the 70 transplants I have done on children, I can recall only three instances when a father donated for a daughter. Though she is cured, she will have to be on anti-rejection medicines for the rest of her life.””  

Apollo Hospitals launches robot-assisted procedures as a better alternative to laparoscopy for Bariatric Surgery. Addressing a press conference on Tuesday, Dr. Rajkumar Palaniappan, consultant, Apollo Hospital, said that robotic surgery provided good or even better results than laparoscopy. The downside was it would cost at least Rs.1.75 lakh more than a laparoscopic procedure. Advantages The advantages included high precision, increased ergonomic flexibility of the robotic arm inside a patient’s body, lesser blood loss, a pain score of 4/10 as compared to 6/10 for laparoscopy and quicker turnaround time for the patient. Robotic-assisted surgery has applications for all three standard bariatric surgery protocols – gastric band, sleeve gastrectomy and gastric bypass. The hospital is also looking to tap into the other advantage of robotic surgery – remote location procedure – by having a surgeon sitting at the computer console in Chennai operate upon a patient in Kolkata. Apollo Hospitals, which has already introduced robotic-assisted procedure for urology and gynaecology, is also aiming to set up robotic equipment at more of its centres. “”Training in this speciality is easier with a surgeon able to pick robotic-assisted surgery skills in a year or so while it takes five to six years for an open procedure surgeon to master laparoscopy””, Dr. Palaniappan said. A training programme in robotic bariatric surgery has also been proposed to be started. Michael Cameron, a patient from Scotland, said that he decided to undergo robotic bariatric surgery at Apollo as his efforts at dietary control failed to provide a lasting solution to his obesity.